A nurse is assisting in the care of a client who is 36 weeks of gestation and reported to the clinic for a routine visit. 

Exhibits

Which of the following findings should the nurse report to the provider?.

Choice A rationale :

Scrambled eggs. Taking ferrous sulfate with scrambled eggs is not the optimal choice because eggs contain phytates, which can bind to iron and reduce its absorption. Therefore, it may hinder the effectiveness of the iron supplement, and the client may not receive the full benefit of the medication.

Choice B rationale

A high-fibre meal. While fiber is generally beneficial for digestion and overall health, it is not the best choice to take with ferrous sulfate. Fiber can also interfere with iron absorption in the same way as phytates, potentially reducing the medication's effectiveness.

Choice C rationale

Orange juice. The nurse should instruct the client to take the ferrous sulfate with orange juice. Orange juice is an excellent choice because it is rich in vitamin C. Vitamin C enhances the absorption of non-heme iron (the type of iron found in plant-based sources like ferrous sulfate). By taking the medication with orange juice, the client can maximize the absorption of iron and improve the treatment of iron-deficiency anaemia.

Choice D rationale

Milk. Consuming ferrous sulfate with milk is not advisable. Calcium, present in milk, can inhibit the absorption of iron. Therefore, taking the medication with milk might reduce the efficacy of the iron supplement and not provide the desired therapeutic effect.

Choice C rationale:

This response is correct because black stools are a common side effect of taking iron supplements. Iron can cause the stool to appear black or

tarry due to the way it is broken down during digestion. It does not necessarily indicate a serious issue, especially if the client is not experiencing any abdominal pain or cramping. Educating the client about this expected side effect helps alleviate any concerns they might have about the change in stool colour.

Choice A rationale:

"Go to the emergency room and your provider will meet you there.”. This response is not appropriate in this situation. The client's report of black stools without abdominal pain or cramping is likely due to the iron supplements and does not warrant a visit to the emergency room. This response may cause unnecessary panic and anxiety for the client.

Choice B rationale:

"What else have you been eating?.”. This response is also not the best choice. While it's essential for healthcare providers to gather comprehensive information about a client's diet and lifestyle, in this case, the client's black stools can be directly attributed to the iron supplements. Focusing on other dietary factors might distract from addressing the client's concern about the side effect of iron supplementation.

Choice D rationale:

"Come to the office, and we will check things out.”. This response is not the most appropriate one either. A visit to the office might not be necessary solely based on the client's report of black stools without accompanying pain or cramping. This situation can be managed through education, and the client can be reassured that it is a typical side effect of iron supplements. An unnecessary visit to the office could inconvenience the client and waste both their time and the healthcare provider's time.